Lil' Sunshines registration form

Dear Lil’ Sunshine's Participants and Families,

Welcome to the City of Moreno Valley’s Lil’ Sunshines Program! It is a pleasure to have you join us. We are excited about the opportunity to get to know you and your family.

Lil’ Sunshines is a social recreation program where children of all abilities will enjoy arts & crafts, music & dance, food exploration, skill building, fitness, planned special events, and special guests. Lil’ Sunshines is also a place to make new friends and participate in exciting adventures!

We encourage all parents/guardians to get involved in our program. Want to learn ways to get involved? Contact our Community Services Assistant Coordinator at 951.413.3729.

Please read all the enclosed information. If you have any questions or concerns throughout the year, please feel free to contact Parks and Community Services at: 951.413.3280.

Once again, on behalf of the Moreno Valley Parks & Community Services Department and the Sunshine Adaptive staff, welcome to Lil’ Sunshines!

Program Rules and Regulations

GENERAL INFORMATION: 

Conference & Recreation Center  
Time 4 Tots Room   
14075 Frederick St.  
951.413.3280
Sunshine@moval.org
Children (Ages 5-9)

WHEN: 

First four Fridays of each month, from 5:00 p.m. to 6:30 p.m.*
*Programs and events are subject to change or cancellation.

REGISTRATION:

Child will be registered on a first-come, first-served basis. Registration spaces are limited.
A multi-child discount is available
Advance monthly registration is highly recommended.
REFUNDS must be requested PRIOR to the start of the registered month.
TRANSFERS will be considered on a case-by-case basis.
A 20% processing fee will be assessed for all refunds and transfers.

HEALTH & SAFETY:

Staff are certified in First Aid and CPR. Guardians will be notified of any accidents or injuries. In emergencies, emergency services will be called, and the child may be transported to the nearest medical facility. Keep emergency contact info up to date.
Children with symptoms of illness should stay home. A doctor’s note may be required to return after an illness. In the event of illness during programing, guardians will be asked to take the participant home. If a contagious illness is reported within the programming, guardians of potentially exposed children will be notified, excluding common colds and minor gastrointestinal viruses.

CHILD ABUSE REPORTING: All staff are mandated reporters under California law. Child abuse is defined as, but not limited to:

Non-accidental physical injury
Willful cruelty or unjustifiable punishment
Sexual abuse or exploitation
Neglect, including failure to provide adequate care

Staff are trained to act when there is reasonable suspicion of abuse.

PARENT/GUARDIAN CONCERNS OR GRIEVANCES:

Concerns should be addressed promptly. If possible, begin with the staff member most directly involved. If needed, escalate to the Site Lead or Assistant Community Services Coordinator. Guardians are encouraged to schedule a meeting to discuss concerns openly and reach a timely resolution.

SNACKS AND PRIZES:

Snacks and small prizes can enhance the enjoyment of our program; however, they are not guaranteed to be available at every session. Parents/Guardians and Participants are welcome to donate approved snacks or prize items for group use. Please be mindful of nut and gluten allergies and provide items that are safe and appropriate for sharing. See the list of approved items below:

Snacks:

Fruits or vegetables
Dried fruits
100% fruit snacks
Pretzels, granola bars, chips, Goldfish, etc.
Candy
Juice or water

Prizes:

Art Supplies
Small puzzles or games
Sensory-friendly items (stress balls, fidgets, etc)

PARTICIPANT CODE OF CONDUCT:

We want participation in this program to be a fun and positive experience for everyone. To make that happen, everyone plays an important part in creating a safe, respectful, and welcoming environment. Participants can help by:

Showing respect to all participants, staff, volunteers, equipment, and facilities.
Only using appropriate, kind, and positive language with others.
Using caution when playing games and sports to avoid causing harm to self, participants, and staff.
Leaving distracting or inappropriate items at home or safely put away. This includes cell phones and electronics.
- Weapons, or any items that resemble weapons, are not allowed in any city facility or program space. These items MUST be left at home. Bringing them may result in permanent removal from the program.
Follow directions given by program staff and volunteers.
Ask for help when unsure about rules or expectations.
Stay in designated areas and with the group, unless permitted to leave.
Keep physical contact safe and appropriate.
- There is zero tolerance for physical aggression, including hitting, biting, kicking, or pushing. These actions put others at risk and are not acceptable at any time.
Take care of personal hygiene and wear appropriate clothing for each activity.
- Clothing must remain on at all times during the program, including shirts and shoes, unless otherwise required for an activity.
Refrain from aggressive behavior, bullying, threats, or harassment of any kind.

PARENT/GUARDIAN CODE OF CONDUCT:

Parents and guardians agree to:

Support the emotional and physical safety of all participants
Communicate respectfully with staff and other parents/guardians
Refrain from using profanity or aggressive behavior during programming
Ensure timely pick-up and consistent communication
Be role models of respect, fairness, and cooperation

DISCIPLINE POLICY:

If a participant has difficulty following the Code of Conduct, staff will do their best to guide and redirect behavior in a respectful, caring, and inclusive way. Our approach focuses on positive reinforcement, using praise and encouragement to highlight and strengthen good behavior. When needed, staff may provide gentle reminders or use strategies, such as taking a short break from the group, going for a walk outside, or switching to an alternative activity, to help participants reset and participate positively with the group.
If unsafe or disruptive behavior continues, staff may take additional steps, which could include:

Speaking privately with the participant (and parent/guardian, if needed)
Scheduling a conference to discuss ways to support positive behavior
Temporary or, in rare cases, permanent removal from the program

*Please note: Physical aggression - including hitting, biting, kicking, or pushing - may result in immediate removal from the activity and possible removal from future programs. There is zero tolerance for biting or hitting. If such behavior occurs, the participant will be asked to leave, and/or their parent/guardian will be contacted to pick them up immediately. Our goal is to partner with parents/guardians and participants to build a supportive community that encourages learning, growth, and connection. Repeated violations or serious misconduct may bypass steps and result in dismissal without refund.

CODE OF CONDUCT & DISCIPLINARY POLICY ACKNOWLEDGEMENT:

By signing below, I confirm that I have read, understand, and agree to the Participant Code of Conduct and disciplinary procedures. I have reviewed, and I acknowledge these guidelines.

Childs Name

Name of Parent/Guardian (Print)

Signature

Date

All decisions are made to ensure the well-being and safety of all participants. No refunds are issued for dismissal due to disciplinary or conduct-related issues.

Childs Name #1

Age

Birth Date

Childs Name #2

Age

Birth Date

Childs Name #3

Age

Birth Date

Parent/Guardian #1

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone

Please enter a valid phone number.Format: (000) 000-0000.

Cell Phone

Please enter a valid phone number.Format: (000) 000-0000.

Work Phone

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Parent/Guardian #2

Address

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Home Phone

Please enter a valid phone number.Format: (000) 000-0000.

Cell Phone

Please enter a valid phone number.Format: (000) 000-0000.

Work Phone

Please enter a valid phone number.Format: (000) 000-0000.

Email Address

example@example.com

Name

Signature

Date

Emergency Contacts / Authorized Adult Companions:

Any person(s) listed below as an emergency contact/authorized adult companion must be at least 18 years of age and must bring proper identification to each session. Adults will remain with the child throughout the class.

Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Relationship

Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Relationship

Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Relationship

Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Relationship

List anyone below who is not authorized/may not attend with your child(ren):

Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Relationship

Name

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Relationship

Health Information:

Participants Primary Physician/Doctor

Phone Number

Please enter a valid phone number.Format: (000) 000-0000.

Medical Conditions if none put N/A (Please describe i.e. diabetes, allergies, etc.)

Food Allergies if none put N/A (Please describe)

Physical or Neurological Disabilities, if none put N/A (Please describe)

Additional Instructions or Accomodations

I give my child(ren)_________________________________ permission to participate in the Moreno Valley Lil’ Sunshines program that the City of Moreno Valley Parks and Community Services Department is sponsoring. I hereby certify that my child(ren) are in good health, and I have health insurance with _____________________.
I give permission for the minor(s) in my custody to participate in the above-mentioned activity and hereby waive, release, and discharge any claims or right to claim damages for any personal injury or property damage which may have, or which may hereafter occur to the participant as a result of said minor’s participation in said activity. This release is intended to discharge in advance the promoter’s sponsors, employees, officials, and any other involved municipalities or other public entities from and against any liability which may arise out of negligence or carelessness on the part of the persons/entities mentioned above.

Parent/guardian

Signature

Date

PHOTO/VIDEO RELEASE FORM
City of Moreno Valley – Parks & Recreation Programs

On occasion, staff or independent photographers of the City of Moreno Valley may take photographs or videos of participants in our programs, at city parks, or during special events. Please be aware that these are for the Department’s use in future brochures, pamphlets, or other city marketing materials. I hereby give permission for the City of Moreno Valley to videotape and/or photograph my child(ren) participating in these various Parks and Recreation classes, events, or programs. These videos and photographs are to be used to promote the programs to the community of Moreno Valley. The videos will be edited and televised on MVTV-3 and its related media entities at the discretion of the Media & Communications Division, and the photographs will be used in various print mediums. It is further understood and agreed that this waiver, release and assumptions of risk is to be binding on my heirs and assigns.

Please indicate your preference below:

Participant Name:

Parent/Guardian Name:

Signature

Date

Please upload child(ren) birth certificate

Lil Sunshines Registration Form